Publications by authors named "Dannielle Post"

10 Publications

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Caring for carers: Understanding the physical and psychological well-being of carers of veterans in Australia.

Health Soc Care Community 2021 May 28. Epub 2021 May 28.

Allied Health and Human Performance, Alliance for Research in Exercise, Nutrition, and Activity (ARENA), University of South Australia, Adelaide, SA, Australia.

Carers of veterans tend to put their own physical and psychological well-being needs behind the needs of the person they are caring for and often do not seek assistance for their own physical and psychological well-being. Combined, these factors lead to increased risk of acute and chronic illness and mental health issues. It is acknowledged that physical activity independently contributes to improved physical and mental health and may be a driver for mental well-being in carers. The aim of this pilot research was to understand how movement behaviour and health behaviours of carers of veterans in Australia relate to carers' physical and psychological well-being. Assessment occurred between February and July 2019 and included objective, validated measures to examine physical and psychological well-being. To assess the association between physical and psychological factors, correlational analyses were performed. Twenty-eight carers participated in the pilot study (96% female, mean age 61.6 years). Exercise capacity varied, and 84% of carers met the recommended 150 min of physical activity per week, with carers spending 8.6% of their time in moderate-to-vigorous physical activity; and 37.9% of the day sedentary. Psychological health outcomes reflect a population with high distress levels and lower than average mental well-being, but with normal resilience scores. Carers with higher levels of resilience had greater exercise capacity, covering further distance in the 6-min walk test, and as resilience increased, number of sedentary bouts decreased. This research demonstrates that there is a relationship between health behaviours and psychological well-being in carers of veterans and serving personnel. Based on the findings of this pilot study, programmes to support family carers should include information about physical activity, reducing sedentary time, and increasing resilience. Interventions designed to improve physical and psychological well-being should be trialled and evaluated for effectiveness.
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http://dx.doi.org/10.1111/hsc.13449DOI Listing
May 2021

Physical Activity Intensity Cut-Points for Wrist-Worn GENEActiv in Older Adults.

Front Sports Act Living 2020 15;2:579278. Epub 2021 Jan 15.

Alliance for Research in Exercise, Nutrition and Activity (ARENA), University of South Australia, Adelaide, SA, Australia.

This study aims to (1) establish GENEActiv intensity cutpoints in older adults and (2) compare the classification accuracy between dominant (D) or non-dominant (ND) wrist, using both laboratory and free-living data. Thirty-one older adults participated in the study. They wore a GENEActiv Original on each wrist and performed nine activities of daily living. A portable gas analyzer was used to measure energy expenditure for each task. Testing was performed on two occasions separated by at least 8 days. Some of the same participants ( = 13) also wore one device on each wrist during 3 days of free-living. Receiver operating characteristic analysis was performed to establish the optimal cutpoints. For sedentary time, both dominant and non-dominant wrist had excellent classification accuracy (sensitivity 0.99 and 0.97, respectively; specificity 0.91 and 0.86, respectively). For Moderate to Vigorous Physical Activity (MVPA), the non-dominant wrist device had better accuracy (ND sensitivity: 0.90, specificity 0.79; D sensitivity: 0.90, specificity 0.64). The corresponding cutpoints for sedentary-to-light were 255 and 375 g · min (epoch independent: 42.5 and 62.5 mg), and those for the light-to-moderate were 588 and 555 g · min (epoch-independent: 98.0 and 92.5 mg) for the non-dominant and dominant wrist, respectively. For free-living data, the dominant wrist device resulted in significantly more sedentary time and significantly less light and MVPA time compared to the non-dominant wrist.
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http://dx.doi.org/10.3389/fspor.2020.579278DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7843957PMC
January 2021

Some gain for a small investment: An economic evaluation of an exercise program for people living in residential aged care.

Australas J Ageing 2021 Jun 1;40(2):e116-e124. Epub 2020 Nov 1.

Centre for Health Services Research, The University of Queensland, Brisbane, Queensland, Australia.

Objective: To evaluate the cost-effectiveness of a 12-week Exercise Physiology (EP) program for people living in a residential aged care facility.

Methods: A within-study pre- and postintervention design to calculate incremental cost-effectiveness ratios per quality-adjusted life years gained. A health service provider perspective was used.

Results: Fifty-nine participants enrolled in a 12-week program. The program cost was A$514.30 per resident. At a willingness-to-pay threshold of A$64 000, the likelihood of being cost-effective of the program is approximately 60%, due to a small increase in participants' quality of life, as reported by care staff. The model showed great variance, depending on who rated the participants' quality of life outcomes.

Conclusion: It is uncertain that a 12-week EP program is cost-effective based on the evidence of the current trial. However, it appears that a low-cost program can produce small improvements for residents in care facilities.
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http://dx.doi.org/10.1111/ajag.12875DOI Listing
June 2021

Feasibility and Process Evaluation of a Need-Supportive Physical Activity Program in Aged Care Workers: The Activity for Well-Being Project.

Front Psychol 2020 30;11:518413. Epub 2020 Sep 30.

UniSA Allied Health and Human Performance, University of South Australia, Adelaide, SA, Australia.

The need to undertake pilot testing and evaluation of novel health promotion programs has become increasingly apparent for the purpose of understanding the true effects of complex interventions and for testing and refining behavioral theories that these interventions are informed by. A mixed-methods process evaluation and feasibility study was undertaken for a need-supportive physical activity program that was piloted in a single-group pre-post study. The piloted program was designed to support participant needs of autonomy, competence, and relatedness through evidence-based and theory-informed behavior change strategies including a motivational interviewing style appointment, education on self-management tools (i.e., pedometers, goal setting, action and coping planning, a customized website for goal setting and self-monitoring), and self-determined methods of regulating physical activity intensity [affect, rating of perceived exertion (RPE), and self-pacing]. The program aimed to positively impact physical activity behavior, psychological well-being, and associated motivational processes. Reach, adoption, fidelity, context, change and performance objectives, and feasibility of the program were evaluated using information from survey respondents from the target population ( = 118) and implementing staff ( = 6); questionnaires from pilot study participants ( = 21); and individual semi-structured interviews with a combination of pilot study participants, non-participants, and implementing staff ( = 19). Process evaluation of the Activity for Well-Being program found that the reach of the program was moderate but adoption was low. The use of self-management tools and self-determined methods of regulating physical activity intensity appeared to be feasible. The website had mixed responses and low engagement. The element of having a support person elicited a strong positive response in the program participant interviews. Involving local implementing staff more directly into the delivery of the intervention could have potentially improved reach, adoption, and feasibility of the program.
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http://dx.doi.org/10.3389/fpsyg.2020.518413DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7554301PMC
September 2020

A cross-sectional assessment of the relationship between sedative medication and anticholinergic medication use and the movement behaviour of older adults living in residential aged care.

PeerJ 2020 24;8:e9605. Epub 2020 Jul 24.

Quality Use of Medicines and Pharmacy Research Centre, Clinical and Health Sciences, University of South Australia, Adelaide, South Australia, Australia.

Objectives: Medications with anticholinergic or sedative effects are frequently used by older people but can increase risk of falls and adverse events; however, less is known about their effect on movement behaviour. Here we examine the cross-sectional association between medication use and movement behaviour in older adults living in residential aged care.

Materials And Methods: Twenty-eight older adults living in residential aged care in metropolitan Australia participated. Medication data were collected from participants' medical charts and sedative load and anticholinergic burden were determined. Seven-day movement behaviour was objectively assessed by a wrist-worn triaxial accelerometer. Raw accelerations were converted to sleep, sedentary time, and time in light, moderate, and moderate-to-vigorous physical activity. To explore the relationship between medication and movement behaviour, Spearman's Rho correlations were conducted, as the data were not normally distributed.

Results: Analyses indicated that while anticholinergic burden was not associated with movement behaviour, sedative load was negatively correlated with a number of variables, accounting for 14% variance in moderate-to-vigorous physical activity (MVPA), and 17% in the bout length of MVPA ( < .02).

Conclusion: The findings of this study showed a negative association between sedative load, due to medicines, and an individual's movement behaviour. The impact of this could be a reduction in the ability of this population to maintain or improve their functional mobility, which may overshadow any benefits of the medicine in some circumstances.
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http://dx.doi.org/10.7717/peerj.9605DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7384436PMC
July 2020

Evaluation of an implementation project: The exercise physiology in aged care program.

Geriatr Gerontol Int 2020 Jun 17;20(6):595-601. Epub 2020 Apr 17.

Helping Hand Organisation, North Adelaide, South Australia, Australia.

Aim: It is important for older adults to maintain the ability to be physically active, and to experience the benefits that physical activity brings. This study evaluates a 12-week Accredited Exercise Physiologist-led exercise program for vulnerable older adults living with dementia, delivered in a residential aged care facility in South Australia. The value of the program was also evaluated from the perspective of partners-in-care (family members and care staff).

Methods: Participants (n = 59) were randomized to either an intervention or control group, based on their functional and cognitive status. Physical function, cognitive function and habitual physical activity were assessed at baseline and post-intervention. In total, 51 family members and 44 care staff completed surveys or participated to understand their perspectives of residents' capacity to exercise, as well as their perceptions of the impact of the program.

Results: Repeated measures ANOVA identified evidence for maintenance of physical function (timed-up-and-go [ɳ = 0.19], handgrip strength [ɳ = 0.13]); however, there were no differences for objectively measured habitual activity or cognitive function. Evidence for a dose effect was demonstrated for the 2-min walk and timed-up-and-go associated with the number of individual sessions attended by a participant. Partners-in-care perceived greater improvement compared with deterioration across all measured factors [(P < 0.01, partial eta (ɳ ) =0.19] ranged from 0.35 to 0.78) post-intervention. Perceptions and expectations of who could benefit from participation were changed (P < 0.05) and indicated that all but the most severely declined residents would be likely to benefit.

Conclusions: Data supporting the maintenance for some physical functions suggest that this type of program should be considered for older adults living with dementia in residential aged care facilities. Geriatr Gerontol Int 2020; ••: ••-••.
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http://dx.doi.org/10.1111/ggi.13923DOI Listing
June 2020

Challenges associated with physical assessments for people living with dementia: Modifying standard assessment protocols.

SAGE Open Med 2020 28;8:2050312120910359. Epub 2020 Feb 28.

NHMRC Cognitive Decline Partnership Centre, The University of Sydney, Sydney, NSW, Australia.

Objectives: Regular physical activity for older adults as they age is important for maintaining not only physical function but also independence and self-worth. To be able to monitor changes in physical function, appropriate validated measures are required. Reliability of measures such as the timed-up-and-go, five-repetition sit-to-stand, handgrip strength, two-minute walk, 30-second sit-to-stand, and four-metre walk has been demonstrated; however, the appropriateness of such measures in a population of adults living with dementia, who may be unable to follow instructions or have diminished physical capacity, is not as well quantified. This study sought to test modified standard protocols for these measures.

Methods: Modification to the standard protocols of the timed-up-and-go, five-repetition sit-to-stand, handgrip strength, two-minute walk, 30-second sit-to-stand, and four-metre walk was trialled. This occurred through modification of procedural components of the assessment, such as encouraging participants to use their hands to raise themselves from a seated position, or the incorporation of staged verbal cueing, demonstration, or physical guidance where required. The test-retest reliability of the modified protocols was assessed using Pearson's correlation, and performance variances were assessed using the %coefficient of variation. Intraclass correlations were included for comparisons to previous research and to examine measurement consistency within three trials.

Results: At least 64% of the population were able to complete all measures. Good test-retest reliability was indicated for the modified measures (timed-up-and-go = 0.87; five-repetition sit-to-stand = 0.75; handgrip strength = 0.94; two-minute walk = 0.87; the 30-second sit-to-stand = 0.93; and the four-metre walk = 0.83), and the %coefficient of variation (7.2%-14.8%) and intraclass correlation (0.77-0.98) were acceptable to good.

Conclusion: This article describes the methodology of the modified assessments, presents the test-retest statistics, and reports how modification of the current protocols for common measures of physical function enabled more older adults living with dementia in a residential aged care facility to participate in assessments, with high reliability demonstrated for the measures.
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http://dx.doi.org/10.1177/2050312120910359DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7052450PMC
February 2020

Efficacy of theory-informed workplace physical activity interventions: a systematic literature review with meta-analyses.

Health Psychol Rev 2020 Jan 29:1-25. Epub 2020 Jan 29.

Alliance for Research in Exercise, Nutrition and Activity (ARENA), School of Health Sciences, University of South Australia, Adelaide, Australia.

This review aimed to assess the efficacy of workplace physical activity interventions; compare the efficacy of those that were and were not informed by behaviour change theory, and outline the effectiveness of different intervention components. A search was undertaken in Medline, Embase, PsycINFO, Ovid Emcare (previously CINAHL) and SportDiscus. Randomised, non-randomised and cluster-controlled trials with objectively measured physical activity and/or measured or predicted maximal oxygen uptake (VO) as outcomes were included in the review (83 papers from 79 trials). Random-effects meta-analyses of mean differences were undertaken. Workplace physical activity programmes demonstrated positive overall intervention effects for daily step counts (814.01 steps/day; CI: 446.36, 1181.67;  < 0.01;  = 88%) and measured VO (2.53 ml kg min; CI: 1.69, 3.36;  < 0.01; = 0%) with no sub-group differences between theory- and non-theory informed interventions. Significant sub-group differences were present for predicted VO ( < 0.01), with a positive intervention effect for non-theory informed studies (2.11 ml.kg min; CI: 1.20, 3.02;  < 0.01;  = 78%) but not theory-informed studies (-0.63 ml kg min; CI: -1.55, 0.30;  = 0.18;  = 0%). Longer-term follow-ups ranged from 24 weeks to 13 years, with significant positive effects for measured VO (2.84 ml kg min; CI: 1.41, 4.27;  < 0.01;  = 0%). Effective intervention components included the combination of self-monitoring with a goal, and exercise sessions onsite or nearby. The findings of this review were limited by the number and quality of theory-informed studies presenting some outcomes, and confounding issues in complex interventions. Future researchers should consider rigorous testing of outcomes of theory-informed workplace physical activity interventions and incorporate longer follow-ups.
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http://dx.doi.org/10.1080/17437199.2020.1718528DOI Listing
January 2020

Development of a Self-Determination Theory-Based Physical Activity Intervention for Aged Care Workers: Protocol for the Activity for Well-being Program.

Front Public Health 2018 26;6:341. Epub 2018 Nov 26.

Alliance for Research in Exercise, Nutrition and Activity (ARENA), School of Health Sciences, University of South Australia, Adelaide, SA, Australia.

Despite the well-established benefits of regular participation in physical activity, many Australians still fail to maintain sufficient levels. More self-determined types of motivation and more positive affect during activity have been found to be associated with the maintenance of physical activity behaviour over time. Need-supportive approaches to physical activity behaviour change have previously been shown to improve quality of motivation and psychological well-being. This paper outlines the development of a need-supportive, person-centred physical activity program for frontline aged-care workers. The program emphasises the use of self-determined methods of regulating activity intensity (affect, rating of perceived exertion and self-pacing) and is aimed at increasing physical activity behaviour and psychological well-being. The development process was undertaken in six steps using guidance from the Intervention Mapping framework: (i) an in-depth needs assessment (including qualitative interviews where information was gathered from members of the target population); (ii) formation of change objectives; (iii) selecting theory-informed and evidence-based intervention methods and planning their practical application; (iv) producing program components and materials; (v) planning program adoption and implementation, and (vi) planning for evaluation. The program is based in Self-Determination Theory (SDT) and provides tools and elements to support autonomy (the use of a collaboratively developed activity plan and participant choice in activity types), competence (action/coping planning, goal-setting and pedometers), and relatedness (the use of a motivational interviewing-inspired appointment and ongoing support in activity).
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http://dx.doi.org/10.3389/fpubh.2018.00341DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6275311PMC
November 2018

Exercise physiology in aged care: Perceptions and acceptability from the perspectives of family members and care staff in the residential aged care environment.

Dementia (London) 2020 Oct 29;19(7):2152-2165. Epub 2018 Nov 29.

University of South Australia, Australia; NHMRC Cognitive Decline Partnership Centre, University of Sydney, Australia.

As we age, maintaining physical functionality is important with respect to wellbeing and healthy ageing. For older adults with dementia this may be difficult, particularly in the residential aged care environment. This article reports the qualitative examination of an Exercise Physiologist-delivered exercise programme for residents with dementia. Perspectives related to the perceived impact and acceptability of the programme, as well as barriers to implementation, and delivery of exercise to residents, were sought from family members and care staff through semi-structured interviews. Benefits related to physical and social factors were identified, and perceptions related to who might benefit from exercise were changed as a result of observing residents participate in the programme. These findings support the notion that an Exercise Physiologist-delivered exercise programme, with a person-centred approach, can contribute to improved functionality for residents with dementia.
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http://dx.doi.org/10.1177/1471301218816246DOI Listing
October 2020
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